You should consider referring a patient with alcohol use disorder to specialist services if they show signs of moderate or severe alcohol dependence NICE. Referral is also appropriate if the patient has failed to benefit from structured brief advice and an extended brief intervention, and wishes to receive further help for an alcohol problem NICE. Additionally, consider referral if the patient exhibits signs of severe alcohol-related impairment or has a related co-morbid condition, such as liver disease or alcohol-related mental health problems NICE.
For patients with a significant comorbid mental health disorder or those assessed to be at high risk of suicide, referral to a psychiatrist is recommended to ensure effective assessment, treatment, and risk-management plans are in place NICE CG115. If depression or anxiety persists after 3 to 4 weeks of alcohol abstinence, assess the condition and consider referral and treatment in line with the relevant NICE guideline for that particular disorder NICE CG115. Furthermore, if staff are not competent to initially assess the need for an intervention, they should refer the patient to a service that can provide such an assessment NICE CG115.